Alfred Korzybski, the father of general semantics, first uttered what must now seem like a well-worn phrase: “The map is not the territory.” And yet, I don’t think this view has yet been well-incorporated into human culture.
In a time when social media outlets are trying to sort what is “fake” from what is “genuine” or “true,” very little thought is being put into what we even mean by “fake,” “genuine” or “true.” Facebook, for example, has resorted to third-party fact-checkers, a mix of news organizations and fact-checking nonprofits. It is also hiring thousands of new employees to check what it calls “non-news” information posted on Facebook pages.
A lot of checking revolves around whether someone said or did what is claimed. That’s not too hard. The next level involves the effect of a policy or position. That’s more difficult since some of the policies in question aren’t in effect and even for those that are, it is always hard to trace cause and effect from a policy to a specific result.
Then, there are what I’ll call “model” questions. Some claims fit into one model, but not into another. So, it’s very important to know what model one is using. In physics what’s true in our everyday experience isn’t true in the world of quantum mechanics, the domain of the very small. For example, it takes time for information, say, in the form of electrical signals through a cellphone network, to travel from where I am in Washington, DC to a client in Eastern Europe. We notice ourselves overlapping in our conversation sometimes because of the delay.
In an actual experiment of quantum effects, electrons that were a mile apart influenced each other with no time delay, suggesting that information at this level somehow travels instantaneously from one place to another. It’s a weird result, but consistent with the theory.
No competent physicist would suggest that relativity (a theory about gravity and the very large) can explain everything we know about in the universe or that quantum mechanics can. Both theories seem necessary for now to explain different phenomena.
So now, let me return to Facebook where howls of protest were registered when the company took down more than 80 alternative health pages. I’ve never been to the pages listed and so don’t know what content was on them. But in reading the titles some seem focused on organic food or meditation. The first topic now has a food label sanctioned the U.S. Department of Agriculture and other agencies around the world and the second deals with an age-old spiritual and health practice.
Yet others may have been touting cures from proper diet or herbs; I cannot know for sure. Facebook provided no information about why the pages were taken down other than that they violated Facebook’s terms of service.
The one thing that seemed to unify them, however, was that they are not touting pharmaceuticals or surgery as answers to one’s health problems. Both options may be perfectly appropriate depending on circumstances. But they aren’t the only paths to health.
And here, based solely on the titles of the pages in question, I began to ask what model of human health was being applied in these cases to evaluate the veracity of the claims made. I would guess it is the narrow biomedical model which imagines the body as a bioelectrochemical machine. That model has shown its effectiveness in many cases. But it is mostly based on treating disease states as defined by the model through pharmaceuticals and surgery, not maintaining optimum health.
Psychiatry is considered a branch of medicine even though it deals with the psychological lives of patients. Psychiatry has also moved medicine toward recognizing that the mental state and attitude of patients is a critical part of their recovery. No sensible physician would argue otherwise.
Going ever further outside the narrow biomedical model, community medicine, for example, looks at environmental, occupational, socio-economic, educational and public health factors in the whole community in determining the causes and best treatments for disease. It also emphasizes prevention. So, it turns out that modern medicine works from a variety of models depending on the needs of patients and the problems to be addressed.
Full disclosure: I use alternative health treatments and do consulting work in the alternative health field. But recently, I took a course of antibiotics because it seemed like the best and wisest course of action given the circumstances. I apply different models based on circumstances without having to reject any that seem useful.
And, usefulness is ultimately how we should judge models which are, after all, just maps and not the actual territory. The purpose of models is to simplify experience to help us understand and order it. No model can account for everything because then it would no longer be a model; it would actually be everything.
In medicine, in other areas of science, in social sciences and even in philosophy, we treat models too often as truths rather than shorthand attempts to describe the world around us for purposes we choose.
This is not to denigrate well-supported models based on widespread observations and experimental evidence such as climate models. We build models in order to judge risks and benefits. One of the best supported set of scientific models ever built is for climate change, involving tens of thousands of scientists across the globe who through meticulous data collection and experimentation have arrived at a very strong consensus. We should note that various models are part of that consensus because they come to similar conclusions and those models are constantly being adjusted based on new information—information that so far suggests we’ve consistently underestimated the speed with which climate change is happening.
Even these scientists can’t predict the future, but they can tell us quite convincingly what risks we face if we don’t act on climate change. And, their general predictions keep coming true by the day.
But, where a model doesn’t serve us well, we should look to other models. Modern medicine is superb at intervening in infectious disease (usually with antibiotics), using trauma surgery to put people back together, correcting physical defects or damage with cosmetic or orthopedic surgery, and preventing life-threatening disease with vaccines.
But modern medicine does a miserable job with chronic diseases such as diabetes which seems related to diet, lack of exercise, social factors which encourage poor eating habits and a sedentary lifestyle, and occupational and public health factors that include environmental exposure to toxins which affect the endocrine system. Modern medicine seeks to manage diabetes. Alternative approaches based on different models of health and illness seek to eliminate it.
The nice thing about models is that often you can try them out and see how they work. If they don’t work, you can do some research and try another model. We are still a species that learns much of what we know by trial and error.
As the stakes rise, our care should rise in what model we experiment with. If for example, I’m a person trying various regimens to treat my frequent heartburn, I can try lots of approaches likely without hurting myself or others. If I am suffering from a potentially fatal cancer, I must weigh the risks of various models carefully to decide how to proceed, and I may not have lots of time for experimentation. But first I have to be aware that there is more than one model of health and illness to choose from!
When the fate of global society is at stake as it is with climate change, we need a mechanism for agreeing on a model that evaluates risk properly in order to take concerted action. We cannot say that our climate model is inexact and so can be ignored. All models are inexact. Their purpose is to give us a basis for taking action. In those cases involving huge societal risks we need a plan for closure and common action. In cases that involve the health of the individual, we need to be more open to experimentation that will allow for additional understanding and testing of various models.
There is a point at which the health of individuals becomes a public health issue if enough people are suffering from the same problem and that problem needs to be addressed on a systemic basis. The role of environmental toxins comes to mind (though because of the powerful interests invested in continuing the release of these toxins it seems doubtful we will ever get serious about them). To the extent that we can, however, we should look to the effectiveness of our models to see how they are performing rather than choose one model for ideological reasons or for reasons related to influence and power.
Image: History of Cybernetics and Systems Science (2006). Vanessa Tan. Via Wikimedia. https://commons.wikimedia.org/wiki/File:History_of_Cybernetics_and_Systems_Science.jpg